During an August Public Safety Committee hearing in the state Capitol building on “Female Inmate Sterilization,” a spokeswoman for J. Clark Kelso, the federal receiver overseeing health care in California’s 33 prisons, testified. In a prepared statement, she read with an expressionless face that tubal ligations — where fallopian tubes are cut, sealed or tied — were just part of the overall medical services offered to women inmates. But her words, delivered in a rote-fashioned bureaucratic tone, didn’t come close to explaining the unexplainable.

Why did at least 148 women inmates at two prisons have the life-changing, irreversible surgeries without case-by-case state medical approval as clearly required by law since 1994?

“I guess what I’m trying to say is we had a regulation in place, and for some reason that regulation was not followed,” the spokeswoman said, winding up her allotted time. “And so we had some conflicting information going out to the people in the department. And we think that was an important part of the story.”

Later at the public comment part of the hearing, Misty Rojo walked up to the wood podium. By contrast, the voice of the woman who had served nearly nine years at Valley State Prison for attempted murder was filled with passion. She said the whole issue of “informed consent” went to the heart of the sterilization controversy.

“When you’re in prison, you do what you’re told to do to get out — period!” she reported. “So even in the idea of medical care, if a doctor tells you ‘you should do this,’ you’re automatically inclined to do it, simply because of the environment you’re in. And you’re likely to sign a paper without fully understanding the lifelong ramifications, especially if they hand you a paper. You sign it. That’s it.

“Some people may be happy with that decision,” said Rojo. But at the end of the day, it is non-informed consent. And it’s coercive. Thank you.”

The ultimate birth control

“So, it’s one thing to consent to a gall bladder operation where it’s not going to have like a longitudinal consequence on you, versus sterilization when you’re taking away permanently someone’s ability to have a family in the future,” Cynthia Chandler, former director and current consultant to Justice Now, a prisoners’ rights organization, told The Tidings.

“The idea is that you have to really be sure that you’re not being coerced in getting that consent. In prison, you’re told what to do every single minute of the day under threat of force if you refuse. So it is inherently a coercive environment with a lot of pressure to conform.

“And that’s the reason there’s this federal ban that limits any medical service provider that receives any kind of federal money, which California’s Department of Corrections and Rehabilitations does, from sterilizing people for the purpose of birth control,” explained the adjunct professor at Golden Gate University School of Law. “And to our knowledge, there’s no other reason why you would do a tubal ligation other than for birth control.”

So what are the pressures? How do they work? Why would an inmate ever agree to ending her reproductive life?

Chandler, who’s spent hundreds of hours visiting female inmates in California’s prisons, says the scenario isn’t really that hard to fathom. 

A woman comes to jail pregnant, embarrassed about being arrested and humiliated by having to undergo strip searchers and other indignities. The food is awful and she can’t get to sleep on the inch-thick soiled mat over cold concrete. At her trial she’s publically mocked before being sent to state prison, where conditions can be even more crowded and deplorable.

Justice Now documented how a pregnant inmate can stand in a state prison’s enclosed 100-degree yard for hours, simply waiting for the most basic prenatal care — vitamins. And when she finally gets to see a doctor, the visit is brief and cursory. In fact, there’s not even the semblance of a birth plan. Why should there be, when her infant is going to be taken away often hours after delivery. And unless a relative is willing to care for the baby, the newborn disappears into the black hole of foster care maybe permanently.

“And then you’re consumed with guilt over being a bad mother and all the stereotypes that go with that,” said Chandler. “Plus you’re told you might die with another pregnancy. And then someone says, ‘You know, I could make this never happen again. You could never have to be pregnant again. You just sign here.’

“I mean, fundamentally, it’s a coercive environment ‘cause it’s such a state of misery,” she stressed. “So it’s not hard to imagine that people would consent.”

The former head of Justice Now believes she knows why at least 148 women prisoners in California were sterilized during the last seven years. It harkens back to dyed-in-the-wool early-20th-century eugenicists like botanist Luther Burbank, Los Angeles Times publisher Harry Chandler and Paul Popence, chief researcher for Pasadena’s Human Betterment Foundation.

“In modern civilizations, where the weak and helpless are protected so carefully, it is not possible to depend on Nature to solve the problem of the survival of the unfit,” observed Popence, arrogantly adding, “Sterilization was seen to be not a punishment but a protection, alike to the afflicted and their families, to society and to posterity.”

The only elective care

Cynthia Chandler also thinks it’s very interesting that the only elective medical care offered by the Department of Corrections and Rehabilitation to women prisoners during the last decade was sterilization.

“To me that speaks volumes to what their primary concern was around the reproductive health of women of color, because we’re really talking about poor women of color who are the majority of people in prison,” she pointed out. “And to me, I think, they were prioritizing the need to eradicate our society of poor people of color over the healthcare needs, actually, of the patient.”

After a moment, Chandler said, “I don’t see how it isn’t anything but eugenics.”

So does kathleen-domingo, coordinator of respect life in the Los Angeles Archdiocese’s Office of Life, Justice and Peace. “I think it’s very interesting to bring this to light because a lot of people have no idea that this kind of thing is happening,” she said.

“But it shouldn’t be surprising to us. You know, the roots of Planned Parenthood are all eugenics, too. That idea of having fewer people who are undesirable has a long history in our nation, especially in California.”

Domingo said she has faced this same mindset over the years on issues ranging from a decades-old Stanford University study linking lower crime rates to higher abortion rates in the African American community to a current state bill that would repeal the Maximum Family Grant rule under the CalWORKs program.

“It’s the same mentality, I think, that even pervades people of good will who think somehow, ‘We should be allowed to want children and have children,’ and other people shouldn’t. It’s like, ‘We don’t want any more of you, because your kind are the problem.’”

When asked if the sterilization of women inmates was morally akin to abortion and euthanasia, Domingo shot back: “Absolutely! I definitely see it as a life issue. I mean, you cannot tell people that they can’t have children. That’s something the Church has always been very clear on. You have to allow people to live the life they believe is best for themselves.”

Could it happen again?

The July story by Corey Johnson of the Center for Investigative Reporting that broke the prison sterilization story, as they say, went viral on both traditional and social media. From the Los Angeles Times to the New York Times, newspapers across the nation ran feature articles and editorials on it, while bloggers offered their unsolicited opinions from around the world.

California lawmakers vied with each other about who could denounce the sterilizations the loudest. Two hearings were held in Sacramento, and the state auditor was asked on Aug. 22 to make her office’s review of the matter its highest priority. To date, that investigation is still ongoing.

“I think any time officials take the journalism that we do and press forward to act is a good thing,” Johnson said. “And I think the auditor could potentially — because they have access to things that I don’t — really get at the answer to a lot of important questions. And so, that also is a good thing.

“But time with tell,” the investigative reporter cautioned. “It all depends on how much time and resources the audit is given.”

Could it happen again?

“Oh, yeah,” quipped Cynthia Chandler. “If we look at the financial situation of our country and our state, it’s forcing more and more lawmakers to really look for creative ways to save money. One of the biggest spending items that we have is prisons. And people have also really been focusing in on welfare in general, and how do we reduce welfare costs.

“So I think that’s what Dr. Heinrich [the former California prison physician] was talking about: ‘Look, we can do this procedure and then we can save the state money. These people won’t be coming in pregnant. It won’t cost as much to put their children in foster care.’

“I think that kind of argument is a very powerful economic argument,” she said. “So I think the financial situation is right for it. And we’re in a state in which this is very likely to reoccur.”

The fourth and final part of this Tidings series will explore the link between discredited eugenics and modern-day genetics, with its near-future promises of biofabrication and designer babies.    

author avatar
R.W. Dellinger
R.W. Dellinger is the former Angelus features editor. In a career spanning three decades, Bob has told the story of the Church's work for justice and peace through expert analysis, and narrative and investigative reporting from the peripheries of Los Angeles. In 2018, the Catholic Press Association named him ”Writer of the Year."